The battle against the opioid crisis is yet to be won
The opioid crisis is reaching new heights, where President Trump has now declared the situation a public health emergency in order to tackle the epidemic across America, which has claimed the lives of 64,000 US citizens, a steady rise from over 59,000 lives in 2016.
The US is not alone however – Canada is equally witnessing a rise in cases where opioid addiction has claimed up to 4,000 lives.
The opioid crisis is complex issue which has formed a significant undercurrent within the medical profession. Back in the 1990s, US physicians began to utilise opioids in order to treat pain within its prescription services, but at a higher rate than its counterparts in the UK and Asia. The country has consequently become the most prescribed nation in the world, with Canada coming in at a close second.
However, with the arrival of prescription-drug-monitoring programs and increased monitoring of prescription opioids such as Percocet and OxyContin to reduce such over-prescribing, demand for cheaper, illegal and stronger alternatives, such as fentanyl and heroin have moved from behind closed doors, to mainstream use. Numbers have steadily risen, hooking younger age groups and impacting the employment sector, with opioid addiction being one of the lead causes of premature deaths across the country.
Although Trump’s announcement has helped promote awareness of the current crisis, medical treatment remains costly, and with no extra funding put aside, it is unclear how citizens suffering from addiction will be able to the necessary access support, especially those with low incomes or those who live in rural locations. Access to drugs such as Naloxone, which counteracts and reverses the effects of an opioid overdose, remains out of reach for many.
Andrew Kolodny, the co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University, informed The New York Times: “What we need is for the President to seek an appropriation from Congress, I believe in the billions, so that we can rapidly expand access for effective outpatient opioid addiction treatments.
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“Until those treatments are easier to access than heroin or fentanyl, overdose deaths will remain at record-high levels.”
With this in mind, Food and Drug Administration Commissioner Scott Gottlieb has announced that it aims to promote the use of “medication assisted treatment,” in order to rid the negative image and stigma it has adopted and convince those with an addiction to seek essential support.
However, the founder of Insys Therapeutics, John Kapoor, has recently been charged with leading a nationwide bribing scheme involving the use of the painkiller Subsys, which medical professionals were encouraged to overprescribe to patients. Amidst growing public anger, many believe that the medical profession has placed profit above patient care.
Mississippi Attorney General Jim Hood has said: “Pharmaceutical companies have made billions of dollars in profits by misrepresenting to tens of millions of doctors and patients the significant dangers of prescription opioids.”
Nonetheless, the actions of the medical profession are unsurprising, given that financial reimbursement would have been higher if an opioid was given within pain management. realising the long-term impacts, Medicare has now scrapped all queries relating to pain management within its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), undertaken by physicians.
Additionally, Medicaid, under ACA, has become the one essential healthcare provision low-income families and citizens have utilising to gain treatment for addiction, yet this could be scrapped under the Trump administration, creating further complications.
Walmart, the next health tech giant - a timeline
Retail giant Walmart has been building its healthcare division for a number of years, but its recent acquisition of a telehealth firm and the slow down of its clinic expansion suggest its focus has now shifted to health tech. We look at key moments in Walmart's history in healthcare.
Walmart announces plans to provide "full primary care services" by 2020. The plans include opening clinics in underserved, urban areas, where the chain has many existing stores.
A series of “Healthcare Begins Here” events launch at Walmart stores, where consumers are given information on leading healthy lives, as well as free blood pressure, blood glucose and vision screenings, and access to vaccinations.
As part of the organisation's commitment to pursue a more data-centric approach to worker safety, Walmart partners with StrongArm, manufacturers of safety wearables. Staff begin wearing FUSE, a small sensor worn between their shoulder blades that detects injury risk. Within a year, ergonomic injuries decreased by 65%.
Walmart opens its first health centre in Dallas. The 10,000 square-foot "super centre" offers primary care, X-rays and ECG, counselling, dental, optical, hearing and community health services. Prices are affordable regardless of health insurance status.
The same year a partnership with Doctor on Demand is announced, a telehealth company offering mental health services. As part of the agreement Walmart employees are able to access these services for free.
The first health and wellness clinic opens in Springdale, Arkansas, providing primary care, dental care, vision and hearing services as well as behavioural health, fitness and wellness education classes.
Walmart acquires CareZone’s medication management technology. CareZone's app reminds users to take their medication and provides refill reminders. The acquisition complements Walmart's existing pharmacy service.
The Wall Street Journal reports that Walmart is in talks with Verizon to implement 5G wireless service in select sites, to help boost digital health services.
As part of its COVID-19 response, drive-thru testing is offered at hundreds of Walmart Neighborhood Market drive-thru pharmacy sites, free of charge through Humana .
The retail giant teams up with the Department of Veterans Affairs to offer telehealth services to veterans at stores in Wisconsin, Michigan and Iowa.
Walmart Mexico signs a deal with Jack Nathan Medical Corp, a Canadian tech-focused healthcare provider. This will see 153 new medical clinics open within stores across Mexico, taking the total in the country to 203.
Walmart announces it is acquiring MeMD, a multi-speciality telehealth provider. The acquisition will enable Walmart Health to provide access to virtual care across the US. At the same time it is reported that plans to open further clinics are deliberately slowing down.
"Today people expect omnichannel access to care, and adding telehealth to our Walmart Health care strategies allows us to provide in-person and digital care across our multiple assets and solutions" Dr. Cheryl Pegus, executive vice president for Health & Wellness said of the announcement.